The Health Overview and Scrutiny Committee met on Monday 27 April 2026 to discuss significant updates on maternity services and cancer pathways. Key decisions included a review of home birth services, the introduction of new cancer screening initiatives, and a commitment to improving patient access to diagnostics and treatment.

Maternity and Newborn Services (The First 100 Days)

The committee received an update on maternity and newborn services, with representatives from Worcestershire Acute Hospitals NHS Trust (WAHT), Herefordshire and Worcestershire Health and Care Trust (HACT), and the Council's Public Health team in attendance. Justine Jeffery, from WAHT, reported significant improvements in maternity services, which were rated as Good by the Care Quality Commission (CQC) following an inspection in October 2023. The Trust has successfully exited the NHS England Maternity Support Programme and is now monitored by the Integrated Care Board (ICB) and NHS England Region.

A key area of discussion was the review of the homebirth service. Following a Prevention of Future Deaths report by the coroner regarding a homebirth incident in Manchester, and a request from NHS England for all maternity services to review their homebirth provision, WAHT has decided to deliver the homebirth pathway through five smaller Continuity of Carer Teams. This approach aims to ensure a smaller cohort of midwives can maintain their skills and provide a safe and sustainable service.

Improvements have also been made in other areas, including a reduction in waiting times in triage, better communication regarding induction of labour, and ensuring women are aware of their birthplace options. The service has also seen success in reducing the number of women smoking at the time of birth to 4%, down from 8%, through smoking cessation services and a new National Smokefree Pregnancy Incentive Scheme. A pilot service for pregnant women with a raised BMI, Blooming Healthy, has been successful and will be expanded with the introduction of lifestyle coaches.

The committee also heard about the ongoing work to achieve reaccreditation for the UNICEF Baby Friendly programme, with the aim of achieving Gold status in 2027. Vaccination uptake rates for Flu, RSV, and Pertussis were discussed, with ongoing work to improve these rates in collaboration with Primary Care partners.

Regarding national reviews, WAHT has completed all recommendations from the Ockenden reports and is now working to comply with the NHS England 10 Year Plan. The service has received the interim report from Baroness Amos' Independent Investigation into Maternity and Neonatal Services in England.

Councillor Tom Wells raised concerns about the data for Redditch residents, questioning how the Good rating from the CQC inspection reflects their experiences, given the closure of the Redditch maternity unit. The committee was informed that the CQC inspection focuses on the acute service based at Worcester, and that while the Alexandra Hospital in Redditch still provides some care, travel to Worcester for more complex needs is a recognised challenge for residents.

Councillor Taylor highlighted concerns about the future provision of maternity services in light of planned housing growth in North Worcestershire, and the need for strategic planning to meet increased demand. Mary Gay, Deputy Chief Exec for the ICB, acknowledged the population growth and the need to ensure resources are in place, stating that not all services can be delivered in every locality.

The committee also discussed the retention of midwives, which is reported to be positive, with a turnover rate of around 3-4%. However, there is a higher turnover among midwifery care assistants, attributed to lower salaries and limited clinical contact. Efforts are underway to improve recruitment and retention in this area, including taster days and career pathway development.

Update on Cancer Pathway

The committee received an update on the cancer pathway, with presentations from representatives of the Herefordshire and Worcestershire Integrated Care Board (HWICB) and Worcestershire Acute Hospitals NHS Trust (WAHT). The update highlighted progress in early diagnosis, screening programmes, and treatment times, aligning with the National Cancer Plan.

Key initiatives to improve early diagnosis include:

• Cancer Awareness Campaigns: Continued promotion of early signs and symptoms through social media, media articles, and a dedicated Cancer Hub for information.
• FIT@80 Bowel Screening: This programme has been introduced to lower the threshold for detecting blood in faeces, leading to an increase in the diagnosis of colorectal cancers at stages I and II.
• Pancreatic Cancer Early Case Finding: A pilot programme now refers patients over 60 with new-onset diabetes or unexplained weight loss for an urgent CT scan.
• Lung Cancer Screening Programme: This programme will commence in Herefordshire in March 2026 and Worcestershire by March 2027, targeting high-risk populations aged 55-74 with a history of smoking.
• Non-Specific Symptoms (NSS) Pathway: To be implemented by the end of June 2026, this pathway will provide a one-stop clinic for patients with vague symptoms suggestive of cancer.

Screening programmes are performing well, with efforts to improve uptake in specific cohorts, including LGBTQ+ individuals for cervical screening and female seasonal workers for breast screening. Workforce constraints in breast screening remain a national challenge.

Performance against key Cancer Waiting Time standards has improved, with the ICB now ranked mid-table or better regionally for most indicators. WAHT has prioritised diagnostic capacity, including expanding imaging, endoscopy, and pathology services, and planning for an additional Community Diagnostic Centre. Discussions are underway for local PET-CT provision to reduce patient travel.

Specific challenges and improvements were noted in several specialties:

• Dermatology: Recruitment of consultants and advanced practitioners, introduction of tele-dermatology pilots, and re-establishment of One-Stop Clinics have helped to stabilise the pathway and reduce waiting times.
• Urology: Short-term interventions and a long-term sustainability plan are in place to address increased referral rates, with a focus on expanding robotic surgery capabilities.
• Breast Services: A new breast pain pathway has been introduced, and short-term capacity measures are being deployed while longer-term redesign is implemented.
• Lung Cancer: Efforts are underway to address complexity and delays through capacity analysis, pathway reviews, and strengthened coordination with specialist centres.

The Living with and beyond cancer programme continues to be a priority, with the expansion of Personalised Stratified Follow-Up (PSFU) pathways, Health and Wellbeing events, and support groups. The Cancer Services App has over 1000 downloads and provides a trusted source of information.

Councillor Christine Wild shared personal concerns about the pancreatic cancer pathway, highlighting potential inconsistencies in care and the challenges of discharge into the community without adequate support. Mary Gay, Deputy Chief Exec for the ICB, acknowledged the concerns and welcomed feedback from patient groups to address any postcode lottery within Worcestershire.

Councillor Tom Wells raised concerns about the mental health impact of cancer diagnosis and treatment, and the delay in starting treatment for over a quarter of patients. He questioned whether patients are encouraged to attend appointments with a loved one and the availability of support for families. Chris Douglas, Chief Operating Officer at WAHT, confirmed that it is usual practice to encourage patients to bring a loved one and that cancer nurse specialists provide support. He also acknowledged that more resource is needed in some areas, particularly regarding workforce and access to specialist centres.

Councillor Mark Ward inquired about prostate cancer screening, noting higher mortality rates compared to breast cancer. While a national prostate screening programme is under discussion, primary care is commissioned to undertake PSA blood tests. Chris Byrne from Healthwatch highlighted the importance of education for men regarding PSA testing and the variability in GP responses.

Councillor McSweeny raised concerns about the reoccurrence of cancer and the support available for patients in remission. Mary Gay stated that ongoing screening and education for patients to recognise returning symptoms are crucial, and that while cancers can come back, treatments are improving.

Councillor David Taylor raised concerns about the mental health impact on children whose parents are undergoing cancer treatment, particularly for single-parent families. Dr Lisa McNally, Director of Public Health, acknowledged this as a gap and proposed developing specific projects to support children and young people in this situation.

Councillor Sue Eacock asked about oesophageal cancer, noting the lack of screening and the difficulty in early identification. It was confirmed that endoscopy remains the primary method for diagnosis, and while genetics are being looked at nationally, there are no immediate changes to local screening programmes.

Councillor Christine Wild shared her experience of men's reluctance to undergo medical examinations, particularly for prostate cancer, and stressed the importance of early diagnosis.

Councillor Turner highlighted the importance of quick diagnosis to reduce stress and the role of lifestyle choices. Chris Douglas explained that delays can occur due to test processing, reporting, or administrative issues, and that efforts are being made to improve communication of results and patient capacity.

Councillor Mel Fordington, via Councillor McSweeny, asked how councillors can be supported to provide information to residents regarding cancer services. Dr McNally praised the councillors' existing support for public health initiatives and encouraged them to continue promoting healthy lifestyles and bringing forward ideas for health messaging.

Councillor David Taylor raised concerns about transport for family members visiting loved ones with terminal illnesses. Councillor Nick Price, Cabinet Member for Transport, confirmed that the council is looking into linking transport zones to improve access to hospitals.

Councillor Tom Wells shared his positive experience of allocating his divisional fund to health and well-being initiatives, highlighting the valuable work already being done by community groups. Chris Byrne recommended the Health Zone app as a trusted source of information for cancer patients and their carers.

Work Programme

The committee reviewed its work programme for 2025/26. For the June meeting, topics will include urgent patient flow, including the Urgent Community Response Service, virtual wards, and the West Midlands Ambulance Service, as well as neighbourhood health and its impact on long-term conditions.

The committee also agreed to consider the development of a specific project to support children and young people whose loved ones are undergoing cancer treatment, as proposed by Dr Lisa McNally.